Office of Human Resources, P.O. Box 5000, Annandale‐on‐Hudson, NY 12504‐5000 Tel: 845‐758‐7428 Fax: 845‐758‐7826 Email:
[email protected] Please print clearly, Answer all sections. These forms must be completed as part of the new hire process. Position Name Address Age (only if under 18 and a student) Social Security Number 1. Have you ever been employed by or applied for a position with Bard College, under either the same or a different name? If yes, please give application date or employment dates and position held. 2. Are you a citizen of the United States or an alien authorized to work in the U.S.? 3. Have you ever been convicted of any crime (other than motor vehicle violations)? If yes, please describe the nature of the crime & the outcome of the case. Note that conviction of crime is not necessarily a bar to employment. Have you ever been convicted of a felony, or a misdemeanor involving any violent act, use or possession of a weapon or act of dishonesty for which the record has not been sealed or expunged? If so, please explain. Note that conviction of a crime is not necessarily a bar to employment. Complete sections 4, 5, and 6 only if the position for which you are applying requires driving. 4. Driver’s license number 5. Driver’s license classification 6. Have you been convicted of a motor vehicle violation within the past 3 years? If yes, please specify. Have you been driving for at least 3 years? If no, for how long have you been driving? I attest that all information herein is true and complete to the best of my knowledge.